CMS Formulary

Displaying 135861-135870 of 1611142 results.
ID: 135861
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135862
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 135863
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 135864
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 135865
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597620
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135866
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135867
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1996246
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135868
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859081
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 135869
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486691
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135870
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111020
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0